Patient-Tailored Health Literacy Improvement System

描述(由申请人提供)：低健康素养影响了美国9000多万成年人，破坏了医生和护士提供高质量护理的最大努力--估计每年花费730亿美元(医学研究所，2003年)。低健康素养还导致个人和集体公共卫生状况不佳，更容易患上疾病，以及生物恐怖主义等复杂紧急情况。针对这一问题，Healthcare Technologies and Methods(HTM)建议开发一种创新和实用的“患者定制的健康素养改进系统”，并在第一阶段测试其可行性。最初，这一新系统的目标是提高II型糖尿病患者在家庭健康护理中的健康素养和改善自我护理。稍后，预计将扩展到其他卫生场所和医疗条件。这个为患者量身定做的健康素养改进系统将包括：(1)使用集成生态模型的新的多维健康素养筛查工具；(2)帮助患者确定其首选学习方式的问卷；以及(3)为每个患者的健康素养水平和首选学习方式(例如，纸张、互联网、视频和交互式语音应答[IVR])量身定做的健康教育材料。针对不同健康素养水平的量身定制的健康教育材料将被高效和自动地汇编。在第一阶段可行性研究中，Inova VNA家庭健康护士将管理筛查工具和学习方式问卷。根据结果，他们将向30名60岁及以上的新诊断为II型糖尿病的患者分发量身定制的健康教育材料(主题：饮食自我管理)。HTM将通过研究前和研究后的问卷调查，确定护士和患者对该系统的满意度和建议。HTM还将通过研究前和研究后的知识测试来衡量患者对特定健康主题的知识。在第二阶段，HTM将根据第一阶段的经验完善筛查工具、医疗方式问卷和自我护理教育材料。此外，HTM还将为糖尿病自我护理的其他方面开发定制材料。配备了改进和扩展的系统后，HTM将对适当数量的受试者进行随机对照试验(基于功率分析)，以验证筛查工具，并衡量患者自我保健知识和健康结果的改善。在第二阶段完成后，HTM设想将一种用于临床实践的高效和实用的系统商业化，该系统可以不断调整和扩展，供说英语和非英语的患者使用。HTM估计，该公司可以在五到七年内实现每年1000万至1500万美元的许可收入。 公共卫生相关性：为患者量身定做的健康素养提高系统健康素养低导致各种问题，包括个人和集体公共健康状况差、更容易患上疾病以及生物恐怖主义等复杂紧急情况。由于超过一半的美国成年人发现很难理解健康信息--健康计划的覆盖范围，阅读药物说明书，或者理解公共卫生警告，我们的国家远不像它需要的那样健康或安全。通过提出一个促进健康素养的新系统，这个研究项目正在解决一个730亿美元的问题，这个问题是我们国家公共卫生系统和国家安全的基础。

DESCRIPTION (provided by applicant): Low health literacy affects more than 90 million adults in the United States and undermines the best efforts of physicians and nurses to provide high quality care - at an estimated cost of $73 billion per year (Institute of Medicine, 2003). Low health literacy also contributes to poor individual and collective public health, greater susceptibility to diseases, and complex emergencies such as bioterrorism. In response to this problem, Healthcare Technologies and Methods (HTM) proposes to develop an innovative and practical "Patient- Tailored Health Literacy Improvement System" and test its feasibility in Phase I. Initially, this novel system will be targeted to advance health literacy and improve self-care for older people in home health care with Type II diabetes. Later, expansion to other health venues and medical conditions is anticipated. This Patient-Tailored Health Literacy Improvement System will be comprised of: (1) A new multidimensional health literacy screening tool using an integrated ecological model, (2) A questionnaire that helps patients identify their preferred learning modality, and (3) Health education materials that are tailored for each patient's health literacy level and preferred learning modality (e.g., paper, Internet, video and interactive voice response [IVR]). The tailored health education materials will be efficiently and automatically assembled for various health literacy levels. In the Phase I feasibility study, Inova VNA Home Health nurses will administer the screening tool and learning modality questionnaire. Based on the results, they will distribute tailored health education materials (topic: dietary self management) to 30 patients ages 60 and over, who are newly diagnosed with Type II diabetes. HTM will determine the nurses' and patients' satisfaction with the system and suggestions with pre- and post-study questionnaires. HTM also will measure patients' knowledge of the specified health subject with pre- and post-study knowledge tests. In Phase II, HTM will refine the screening tool, modality questionnaire and self-care education materials based on Phase I experiences. In addition, HTM will develop tailored materials for additional aspects of diabetes self- care. Equipped with the improved and expanded system, HTM will conduct a randomized controlled trial with an appropriate number of subjects (based on a power analysis) to validate the screening tool and measure improvements in patients' self-care knowledge and health outcomes. After completion of Phase II, HTM envisions commercializing a system that is efficient and practical for clinical practice and can be continuously adapted and expanded for use by English-speaking and non English-speaking patients. HTM estimates that the company can achieve annual licensing revenues of $10 million - $15 million within five to seven years. PUBLIC HEALTH RELEVANCE: Patient-Tailored Health Literacy Improvement System Low health literacy contributes to a variety of problems including poor individual and collective public health, greater susceptibility to diseases and complex emergencies such as bioterrorism. Because more than half of adults in the U.S. find it difficult to understand health information - health plan coverage, read medication instructions, or understand public health warnings, our nation is not nearly as healthy or as safe as it needs to be. By proposing a new system to advance health literacy, this research project is addressing a $73 billion problem which is at the foundation of our nation's public health system and national security.